CAJ | 학술논문

目的观察生大黄、蒙脱石散联合序贯性血液净化治疗对重度急性有机磷农药中毒(AOPP)的临床疗效.方法 21例用生大黄、蒙脱石散联合序贯性血液净化治疗的患者为联合治疗组,18例同期收治的因经济困难或家属意愿等原因仅行常规治疗的患者为常规治疗组,均为口服中毒.常规治疗组给予常规治疗,联合治疗组在常规治疗的基础上给予胃管内灌入生大黄、蒙脱石散,同时进行序贯性血液净化治疗.结果与常规治疗组昏迷至清醒时间[(8.4±2.4)d]机械通气时间[(10.7±2.9)d],住院时间[(16.5±3.7)d]比较,联合治疗组患者昏迷至清醒时间[(6.5±1.3)d]、机械通气时间[(7.9±2.0)d]、住院时间[(13.1±3.2)d]均明显缩短,差异均有统计学意义(P＜0.05).治疗后第5、6、7天,联合治疗组血清中乙酰胆碱酯酶(ChE)活力明显高于常规治疗组,差异有统计学意义(P＜0.05).与常规治疗组比较,联合治疗组阿托品使用总量、使用时间、氯解磷定使用总量、使用时间均明显减少,差异均有统计学意义(P＜0.05).联合治疗组病死率为19.0％(4/21),明显低于常规治疗组的病死率(44.4％,8/18),差异有统计学意义(P＜0.05).结论生大黄、蒙脱石散联合序贯性血液净化治疗对重度AOPP有较好的治疗效果.
목적 관찰생대황、몽탈석산연합서관성혈액정화치료대중도급성유궤린농약중독(AOPP)적림상료효.방법 21례용생대황、몽탈석산연합서관성혈액정화치료적환자위연합치료조,18례동기수치적인경제곤난혹가속의원등원인부행상규치료적환자위상규치료조,균위구복중독.상규치료조급여상규치료,연합치료조재상규치료적기출상급여위관내관입생대황、몽탈석산,동시진행서관성혈액정화치료.결과 여상규치료조혼미지청성시간[(8.4±2.4)d]궤계통기시간[(10.7±2.9)d],주원시간[(16.5±3.7)d]비교,연합치료조환자혼미지청성시간[(6.5±1.3)d]、궤계통기시간[(7.9±2.0)d]、주원시간[(13.1±3.2)d]균명현축단,차이균유통계학의의(P＜0.05).치료후제5、6、7천,연합치료조혈청중을선담감지매(ChE)활력명현고우상규치료조,차이유통계학의의(P＜0.05).여상규치료조비교,연합치료조아탁품사용총량、사용시간、록해린정사용총량、사용시간균명현감소,차이균유통계학의의(P＜0.05).연합치료조병사솔위19.0％(4/21),명현저우상규치료조적병사솔(44.4％,8/18),차이유통계학의의(P＜0.05).결론 생대황、몽탈석산연합서관성혈액정화치료대중도AOPP유교호적치료효과.
Objective To observe the curative efficacy of rhubard,montmorillonite powder combined with blood purification on treatment for patients with severe acute organophosphorus pesticide poisoning(AOPP).Methods 39 patients with AOPP were divided into treatment group (received the combined treatment of rhubard,montmorillonite powder and blood purification on the basis of routine therapy,n=21) and control group (only received the routine treatment because of financial difficulties or the will of family members,n=18).The differences of clinical manifestations,curative effects and prognosis between two groups were compared.Results The time of consciousness recovery,the duration of mechanical ventilation and the length of stay in hospital in treatment group were (6.5±1.3),(7.9±2.0) and (13.1±3.2) days,which were significantly shorter than those [(8.4±2.4),(10.7±2.9)and (16.5±3.7) days] of control group (P＜0.05).Ⅰ n 5,6 and 7 day after treatment,the cholinesterase (ChE) activities of treatment group were significantly higher than those of control group (P＜0.05).The total amount and using time of atropine and pyraloxime methylchloride in treatment group were significantly smaller and shorter than those in control group(P＜0.05).The death rate of treatment group was [19.0％(4/21 )],which were significantly lower than that of control group [19.0％(4/21 )] (P＜0.05).Conclusion The combined treatment of rhubard,montmorillonite powder and blood purification of the AOPP patients has a better curative effect.